Introduction by Patricia Walter:

Occasionally people have hip device
failures due to pushing too hard right after surgery or
doing hard impact sports or activities too soon.  There are
stories of people with hip resurfacings that required
revisions to THRs.  Dr. Broder, a hip resurfacing
patient and radiologist, explains why patients should be
conservative during their post op recoveries.  Most
surgeons want patients to wait until at least 6 months to
return to normal sports and one year to high impact sports
like running. Using common sense, listening to your
surgeon’s protocols and giving your body time to heal is
always the best approach to returning to a normal activity
level.

Dr. Broder explains:

I am Radiologist, and have been a member
of Yahoo surfacehippy discussion group since 2002. Over the
years we have had numerous members, especially young active
athletes, who have accidentally injured their prosthetic
hip.

Nuclear Medicine bone scans reveal
metabolic activity (new bone growth) persisting for up to 2
years in adults over 30 who sustain fractures, or have had
joint prosthetics. The reason is simple. As the bone heals,
new bone is produced by special cells, and tiny new blood
vessels (neovasculature) which very slowly grow into the
older bone, and the special surfaces of the prosthetic parts
designed for that purpose. Over time, other special cells
reshape the new bone, and eventually it is replaced with
thicker stronger bone tissue. In fact, over time, ALL the
bone in our body is being replaced slowly in response to
various stress factors, and maintenance. This is true of
many tissues in the body.

If we return to certain activities too soon, we will apply
forces that will produce microscopic fractures in the new
bone, and it may fail to completely heal. The complex
process of bone healing is delayed or completely fails. This
is a well known problem in treating fractures of any bone.
That is why cast material is applied, or other methods of
internal fixation (screws, plates, rods), or EXTERNAL
FIXATION methods are used to hold fractured bones in place.
Even slight mobility will result in mal-union, incomplete
union, or even complete NON-UNION which is a very serious
problem. Each person will heal at an individual rate
controlled by complex factors.

Every surface hippy has already arrived at the point where
the NATIVE HIP has failed.

New Hippys to be:
Don’t put your new artificial hip at risk. Follow
instructions. Exercising too forcefully, too soon can lead
to failure of union of the new bone to the hip. This is
especially true of the uncemented portion(s). There is no
magic involved here. Once you have micro-fractured the new
bone, it may never heal properly.

I waited 11 months at age 58 before returning to skiing.

Best wishes,
Michael (MD in NC) (L) C+ 3/31/03